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To evaluate whether a short follicular phase of ovarian stimulation compromises the chance of pregnancy, subjects from a double-blind, randomized trial treated with a single dose of corifollitropin alfa (n=756) or daily recombinant FSH (n=750) were categorized as early responders if three follicles ≥17 mm were reached and human chorionic gonadotrophin (HCG) was administered prior to or on stimulation day 8, and as normal responders if three follicles ≥17 mm were reached and HCG was administered after stimulation day 8. In the corifollitropin alfa and recombinant FSH groups, 23.2% and 29.1%, respectively, were early responders (P=0.01). Regardless of the treatment group, the initial ovarian response was higher in early responders, but with two extra days of stimulation, the number and size of follicles on the day of HCG in the normal responders was similar to those of the early responders. The number of oocytes was similar in both response groups following corifollitropin alfa treatment (13.6 versus 14.5) and recombinant FSH treatment (12.8, both groups). The ongoing pregnancy rates were comparable for early and normal responders regardless of the treatment group, supporting successful outcome following a stimulation period of only 1 week.

Článek

Ovulation stimulation protocols utilizing GnRH-antagonist/hCG, promote cytotoxic cell populations, predominant in patients with embryo implantation complications

Neuro-endocrinology letters. 2013 ; 34 (3) : 249-7.

Neuro-endocrinol. lett.
ISSN 0172-780X
Medvik
Zdroj

OBJECTIVE: Gonadotropin-releasing hormone (GnRH) antagonist combined with the human chorionic gonadotropin hormone (hCG) is commonly used in assisted reproduction techniques (ARTs) to induce controlled ovarian hyperstimulation (COH) and to synchronize oocyte maturation. While hCG is known to have immunomodulatory properties, we aimed to assess its effect on immunological changes, with respect to HLA-G binding receptors and embryo implantation success. DESIGN: The study involved 103 subjects, including patients undergoing COH protocols (n=66), divided on the basis of the pair's fertility disorder (FD) causes (female FD, n=29; male FD, n=37), and age matched healthy women (n=37). The relative distribution of T cell (CD3+/CD4+, CD3+/CD8+) and NK cell (CD56bright/CD16-, CD56dim/CD16+) populations was evaluated together with HLA-G ligands KIR2DL4 and LILRB1 expression by flow cytometry in the peripheral blood of all subjects, as well as in patient follicular fluids. RESULTS: Both groups of patients exhibited a significant decrease of their CD4/CD8 index, a down-modulation of LILRB1-positive CD8 T cells, and increased KIR2DL4-positive NK cell distribution, when compared to the healthy donors. We attribute these changes to the COH protocol, since the only significant change between the patient groups was in the number of cytotoxic CD56dim NK cells (elevated in the female FD group). Patients with male FD causes, having an above-average CD4/CD8 index (≥3.17) and below-average KIR2DL4+/CD56bright NK cell levels(≤13.3%), exhibited higher embryo implantation rates. CONCLUSION: The GnRH antagonist/hCG protocol promotes CD3+/CD8+ and KIR2DL4+ NK cell levels, more abundant in subjects with lower implantation rates, and thus decreases the embryotransfer success in otherwise fertile women.

Článek

Luteální podpora v programu IVF/ET
[Luteal support in the IVF/ET programme]

Michnová, Lucie
Autor Autorita
Rumpíková, Taťána
Autor Autorita
Dostál, Jiří, 1961-
Autor Autorita

Česká gynekologie. 2011 ; 76 (2) : 104-107.

Medvik
Zdroj

Cíl: Cílem přehledového článku je prezentovat problematiku luteální podpory v programu IVF/ET. Typ: Přehledový článek. Závěry: Luteální podpora ve stimulovaných cyklech za účelem IVF/ET je nezbytnou součástí léčby.

Objective: The objective of this article is to review the recent information about luteal support in the IVF/ET programme. Design: Review article. Conclusions: The luteal phase support is a necessary part of treatment in stimulated cycles for IVF/ET.